David and Jill Show #4: Treatment of OCD

David and Jill Show #4: Treatment of OCD

Watch the fourth David and Jill Show on the Treatment of OCD!

Hi all!

The fourth David and Jill Show on the treatment of OCD with guest Mike Christensen will start at 3 PM. Show #3 has set a new record of more than 2 thousand viewers in the first week alone. You can still watch it!

During the show, we will also answer questions from those who attend the show live. We’ll have a lot of energy and ideas to share, so join us if you can!

The Feeling Good Podcast last Monday–live therapy with Daisy–also drew exceptionally well and was enthusiastically received. In fact, this month it looks like we will set a new record with more than 40,000 downloads! Thank you all for your support!

During the session with Daisy, we address the question, “What’s the secret of a meaningful life?” We also discuss the empowerment of women, and the intimidating messages women often hear from society, and from families when growing up. Make sure you catch it if you have not listened yet!

Also, remember to register for the one-day David and Jill workshop on Sunday, May 20, 2018. It’s for mental health professionals. You’ll have a chance to learn the latest TEAM-CBT techniques and work on your own insecurities and feelings of self-doubt as well. We promise to bring roughly 60% of the audience into a state of joyous enlightenment, so don’t miss it!

David

Advanced, High-Speed TEAM-CBT for the Treatment of Depression and Anxiety:
A Workshop for Therapists with Drs. David Burns and Jill Levitt

 

David and Jill Show #3 Sets Record!

David and Jill Show #3 Sets Record!

Watch the Third David and Jill Show on Intimacy Training!

Hi all!

The third David and Jill Show on Intimacy Training with guest Mike Christensen has set a new record of 1.6 thousand viewers in the first two days alone. You can still watch it!

David and Jill begin by reading a question from a viewer named Don who was having a conflict with his girlfriend. David, Jill, and Mike go review the five steps of the Relationship Journal and show how Don how he can transform his argument into a more open and loving dialogue using the Five Secrets of Effective Communication. During the show, Jill notices a live viewer who wrote, “I don’t like Jill” in the comment column. You will LOVE Jill’s masterful response, which illustrates the whole point of the show in real time. Then Mike describes how he bravely handled a painful criticism from his daughter who complained that he sounded phony.

Many people believe that the Relationship Journal is all about learning how to communicate more effectively, but it’s not. It’s really about the “Great Death” of the ego and how to develop interpersonal enlightenment. It’s a spiritual tool, which is exciting, but be careful–the death of the ego can be painful! Of course, the reward of greater trust and love is definitely worthwhile. The third David and Jill Show is definitely a “must see” show, and you can catch it any time that’s convenient for you.

Yesterday’s Feeling Good Podcast–live therapy with Daisy–also drew exceptionally well and was enthusiastically received. During the session, they address the question, “What’s the secret of a meaningful life?” Make sure you catch it if you have not listened yet!

Also, remember to register for the one-day David and Jill workshop on Sunday, May 20, 2018. It’s for mental health professionals. You’ll have a chance to learn the latest TEAM-CBT techniques and work on your own insecurities and feelings of self-doubt as well. We promise to bring roughly 60% of the audience into a state of joyous enlightenment, so don’t miss it!

David

Advanced, High-Speed TEAM-CBT for the Treatment of Depression and Anxiety:
A Workshop for Therapists with Drs. David Burns and Jill Levitt

 

Another Cool Video for You! The “Niceness” Disease!

Another Cool Video for You! The “Niceness” Disease!

Here is another cool short video from Jill Levitt, PhD, who is the Director of Training at the Feeling Good Institute in Mt. View, California, and Taylor Chesney, PhD, who is he Director of Training at the Feeling Good Institute in New York City. But you might enjoy it more if you read the material below the video first!

 

Scenes from a Sunday hike:

 

I have always emphasized the importance of personal healing for therapists, as part of their development as psychotherapists and their growth as human beings. In this video, Dr. Taylor Chesney remembers one of my Sunday hikes when she did some personal healing and came to understand the Hidden Emotion Technique in much greater depth. Something sudden and unexpected happened that had a profound effect on Taylor’s life.

Because Dr. Levitt wasn’t there when Taylor and I were doing our work, I will share a tad of additional information that might illuminate Taylor’s experience while hiking. First, Taylor asked if I could help her with some sudden anxiety she had about transitioning to her private practice at the end of her post-doctoral training. She was extremely anxious and had negative thoughts like, “I won’t get any referrals,” and “My practice will be a failure,” and “I won’t be able to help anyone,” and things along those lines.

Taylor could easily identify the distortions in her thoughts, which included Fortune Telling (making arbitrary negative predictions), Discounting the Positive (since she was highly regarded by everyone in our training program and was already getting many referrals, and had tons of patients who were doing great because of her superb skills), Emotional Reasoning (I feel anxious, so I must be in danger,) and All-or-Nothing Thinking (viewing a private practice as either a smashing success or a total failure) to mention just a few of the cognitive distortions in her negative thoughts. However, Taylor simply could not come up with positive thoughts that effectively crushed the negative thoughts, so she continued to believe them, even though on some level she could see that the negative thoughts were simply not true. She kept clinging to the irrational belief that she’d get no referrals and be totally ineffective in her clinical work, and so forth.

Then I asked myself “why” Dr. Chesney was being so unreasonable, since she was really a sweet, smart, and enthusiastic individual. I began to think about the Hidden Emotion Model, which can be incredibly helpful in the treatment of anxiety, especially when patients seem stuck. The idea behind the Hidden Emotion Technique is that only “nice” people develop anxiety disorders, and it’s often because of some hidden feeling or conflict that the patient has not brought to conscious awareness. The Hidden Emotion or conflict is NOT something that’s buried in the past, it’s something that’s buried in the present–some ordinary thing that’s bugging the patient right now, but you can’t seem to “remember” what it is.

Sometimes the suppressed feeling is a negative one, like anger, but sometimes it can be a positive feeling, which turned out to be the case with Dr. Chesney. And usually, the anxiety is the symbolic expression of the conflict. Once you bring the Hidden Emotion to conscious awareness, and the patient deals with, you will nearly always see a dramatic and sudden reduction in the anxiety, or even a complete elimination of the anxiety.

Essentially, Dr. Chesney seemed to be saying, “private practice won’t work for me and you can’t convince me that I’ll be successful no matter what!” Could it be that some hidden feelings was getting in the way? If you haven’t yet watched the video, take a guess. Then watch the video and you’ll find out what the Hidden Emotion really was! After you’ve finished the brief video, you can link to my final comments if you’re interested in learning a little more.

You can also link to a previous blog on the Hidden Emotion Technique as well as two previous Feeling Good Podcasts on the causes and treatments for anxiety, including the Hidden Emotion Technique:

023: Scared Stiff — What Causes Anxiety? What’s the Cure? (Part 2)

027: Scared Stiff — The Hidden Emotion Model (Part 5)

David

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and tons of resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

Video Endorsement / Online TEAM-CBT Classes!

Video Endorsement / Online TEAM-CBT Classes!

 

Hi friends and colleagues,

You might enjoy this video from Mike Christensen, one of the rising stars in TEAM-CBT. He is about to start a 12-week online introductory course in TEAM-CBT limited to 14 therapists. There are only a couple slots left, so email him ASAP if you are interested. Mike is a terrific teacher and therapist, and a very compassionate individual! Highly recommended!

You will find a list of additional in-person and online training groups if you click here. Many of the groups are sponsored by the Feeling Good institute in Mt. View, California.  I endorse the training groups enthusiastically, but do not receive any financial compensation for endorsing them. I know they are wonderful teachers and I take great pride in what they have accomplished and satisfaction in supporting their efforts! You will also find information on many weekly in-person training groups, including my own 2 1/2 hour training group every Tuesday evening at Stanford, and it is totally free of charge. For details, click here.

David

 

Here is a cool endorsement for Mike Christensen that just arrived in my mailbox today (Monday, May 8, 2017), following publication of this blog:

Hi everyone,

I can attest to Mike’s skill, passion and all-around great-guy-ness. Anyone could learn a ton from him and enjoy themselves thoroughly in the process. If you are thinking about this class…. just do it!!

Dr. Annie Hanaway

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

How to Find Your “True Calling” in Life!

How to Find Your “True Calling” in Life!

Dear David,

First of all, I would like to tell you that using the methods in your many wonderful books has changed my life!!

I have a question and it would be great to get your input. I work as a team leader/software engineer in a software company. I like my profession (I enjoy programming and managing) but I also care deeply about the environment and animals. (I also volunteer in an environmental non-profit organization). This situation leads to a recurring thought that causes me a lot of suffering: “I’m wasting my life when I’m working in this job (software).”

I feel that my life calling is working with animals/helping the environment and as long as I’m not working at that I’m wasting my life. Is this true? Am I wasting my life?

Is this the hidden emotion (elephant in the room) that causes this thought?

I really need your help!

Thanks, Sharon (name disguised)

 

Hi Sharon,

Thanks for your questions! It is spirit-uplifting that you have idealistic goals. My wife and I are also concerned about the environment and the welfare of animals.

I cannot give medical advice, or do therapy in this medium. I can only give some general ideas, but perhaps you will find them useful or interesting.

First, this might be the Hidden Emotion phenomenon, and it might not be. For example, let’s say there’s something else that’s bothering you that you are kind of pushing out of your mind. Perhaps there’s a conflict of some kind with a boyfriend, or a girlfriend, or a family member. Or perhaps someone is pushing you to loan them money, and you are tempted to give in because you’re so “nice,” but you don’t really want to. Or maybe there is a problem of some kind at work that you’re avoiding. It could be anything.

These are just examples of the kinds of conflicts that overly “nice” individuals sometimes tend to avoid.

If this is going on, then the obsessing about your career could, in fact, be a way of not dealing with the real issue. If this turns out to be the case, then you are a darn good detective! But you’re the only one who will be able to say one way or the other. If you open your mind to this possibility, some problem you’ve been avoiding might suddenly pop into your mind. Then if you deal with it more directly, the obsessions about your career might diminish or suddenly disappear. But this is just a possibility.

On the other hand, it might not be the Hidden Emotion phenomenon, but simply genuine ambivalence about your career. You do enjoy your career, which is great, but you are telling yourself that you “should” be doing something more meaningful with your career and with your life. Should Statements are one of the ten cognitive distortions, as you may know if you’ve read any of my books or listened to my two podcasts on negative and positive distortions.

We could view your career concerns as a genuine decision-making issue, but there are really two different decisions involved. The first decision is whether or not you want to change careers. The second decision is whether or not you want to beat yourself up by telling yourself, “I’m wasting my life because I’m working in software development.”

It might be useful for you to do a Cost-Benefit Analysis. Draw a line down the middle of a piece of paper and label the left-hand column Advantages and the right-hand column Disadvantages. You can put the negative thought that is bothering you at the top of the page. This is the thought: “I’m wasting my life working in software.”

Then list the Advantages and Disadvantages of believing that thought and beating up on yourself about your career, and balance them against each other on a 100-point scale. Is it 50-50? 60-40>? 35-65?

To make this easier for you, I’ve attached a CBA for that you can download if you CLICK HERE. You will see that your negative thought is already at the top of the page for you.

Notice that this is NOT a decision about your career. It is a decision about obsessing and making yourself unhappy about your career.

One advantage of telling yourself that you are wasting your life is that it might motivate you to change professions, so you will be more likely to pursue your goal. Another advantage might be that your self-criticism shows that you are a very caring and idealistic person, and not someone who ignores real problems in our society. A third advantage might be that your negative thought could be a kind of “moral punishment” for doing what you enjoy—software development! After all, many cultures and religions throughout history have felt that it is a sin to be happy and to enjoy yourself!

Another advantage of criticizing yourself is that it shows how humble you are, and how willing you are to examine your life in a serious and accountable way. And humility is a spiritual quality.

Yet another advantage is that your self-criticisms show that you have high standards, and those high standards have likely motivating you to accomplish a great deal in your career! And that’s definitely a good thing.

You can likely think of more advantages, and I’m just giving examples.

And you may conclude, after making this list, that you want to keep criticizing yourself. There is nothing wrong with that!

Then you could list any possible disadvantages of your negative thought in the right-hand column. For example, if you are not actually planning to change professions any time soon, then one disadvantage would be that you’re making yourself unhappy, and perhaps unnecessarily. And you might be able to list some more disadvantages as well.

After you complete you lists, put two numbers that add up to 100 in the circles at the bottom. The critical issue is not how many things you list in each column, but how they weigh out in your mind. What feels greater? The Advantages? Or the Disadvantages?

If the Advantages of the negative thought are greater, and you decide that that DO you want to continue criticizing yourself in this way, you could be to ask yourself how many minutes per day you want to devote to beating yourself up. Would five minutes be enough? Thirty minutes? Then you could schedule time each day to sit and make yourself miserable with a barrage of self-critical thoughts. At the end of your scheduled “Worry Break,” you could go back to joyous, happy living.

In addition, you could do two additional Cost-Benefit Analyses (CBAs). First, you could list the advantages and disadvantages of sticking with your current career. Then you could do a second CBA, listing the advantages and disadvantages of switching to some type of career involving your love of animals or your commitment to saving the environment.

Here’s something else to think about that might also be interesting to you. There is no rule that says that you have to have one supreme “calling” in life that you totally devote yourself to. It can be more than enough just to have a job to support yourself. And if you enjoy your work, so much the better! And that might be enough to ask from your work as a software engineer.

You can still do things in your spare time, if you want, to pursue more idealistic causes, or other interests, and it sounds like you are already doing this. On my Sunday hikes with individuals from my free weekly TEAM-CBT training groups at Stanford, we see volunteers in the Palo Alto Foothill Park removing invasive plants and weeds that do not belong in this area. They are doing something for the environment.

In my case, I devote a lot of volunteer time each year teaching and training therapists, and even helping them with personal issues in my training groups for community therapists at Stanford, and during our Sunday hikes as well. It is all totally free,, and it gives me a lot of pleasure!

My wife and I also devote enormous time to abandoned cats that we take in, and we absolutely love them! We have a small orchard and grow tons of apples that we feed to the many grateful deer in this area in the fall. The deer sometimes make a home in our front yard and sleep under our old plum tree! We love them! When they are hungry, the mother deer comes close to our house and stares into one of the windows. When I notice that, I go out and toss out about 75 or 100 apples for them, which they quickly devour!

You can also support political candidates who support your goals and causes.

In short, life does not have to have one calling, one purpose, or one meaning. You can have as many goals, purposes, and meanings as you want! The idea that your MUST have a career that involves some lofty goal is often just a trap, just another “should.”

Do you know that in the middle of my psychotherapy career, I suddenly got the urge to pursue a career in table tennis? That might sound goofy, but it’s true!

I had been really good in table tennis as a kid, and in college, too, but had never had any formal training. So I completely gave up my clinical practice and purchased a ball machine and video camera in the garage, and hired a professional table tennis coach who called himself Ernie the Black Pearl of the Caribbean. He had just moved to Philadelphia and was looking for people to coach, so I paid him to coach me 20 hours a week for about six months. He was the Caribbean champion and was phenomenally skillful. It was strenuous Olympic type training for four hours each morning, Monday through Friday.

I also purchased an Olympic table tennis table from Sweden, as well as costly Swedish rackets with special rubber on both sides that created increased spin and speed when you hit the ball.

Oh boy! I worked and worked on my table tennis. The game had changed completely from when I was a kid, so the training involved a lot of re-learning.

Then I saw a notice that there was going to be a four-day training camp at the Eastern Regional Table Tennis Training Center in Bethesda, Maryland. It appeared to be a training program for the US Olympic Team, and I called to ask if my son and I could attend. The woman who answered inquired about my national rank, and I explained that I did not yet have a rank, but that we were pretty good, etc etc. So agreed to register my son—who was about 15—and me in the program.

This was the chance of a lifetime! We were so excited that we got up at about 4 AM and drove from Philadelphia to Bethesda at 80 miles an hour the first morning of the program. We were the first to arrive, and the woman who greeted us at the door was the former US women’s table tennis champion. It was an amazing huge facility with Olympic tables and runways surrounded by fences so you’d have a large protected area to play at each table. She said my son and I could warm up while the other candidates were arriving.

We set each other up for slamming the ball, and I was thinking she’d be pretty impressed!

Then the other candidates starting arriving. They were these super athletic looking young men, and they brought their children with them. I thought, “Wow, that is so neat that these Olympic table tennis players are bring their children to watch!

About 25 people arrived, and then she announced, “Those who are registered for the four day training program please sit on this long bench.” My son and I jumped up eagerly and sat of the bench.

But to my dismay, as the other candidates arrived, we discovered it was a training program for children! This was NOT the Olympic team! My son and I were the oldest people there, except for one teenager who was 16!

Then she said she would match us up with other players to play a five game match, to see what our skill levels were. She matched me against an 11 year old named Jimmy who looked pretty nerdy. He had horn rimmed glasses and was barely tall enough for his head to be above the level of the table.

I thought, “Oh no, this is going to be pathetic. I’m going to crush this poor little boy, and it might demoralize him.

Before we started I asked him if he played a lot of table tennis, and if this was his main interest. He said, “I do play a little table tennis, doctor, but my main thing is squirrel hunting.”

To determine who serves first,  you hide the ball under the table in your right or left hand, and your opponent has to guess what hand it is in. If your opponent guesses correctly, he or she gets to serve first. But Jimmy generously said that wasn’t necessary and I could choose whether I wanted to serve or receive first.

I told him I wanted to serve, because I had learned these incredible, high-speed spinny serves that are virtually impossible to return in Sweden during a visit I made when I was in medical school. So I gave him a mind-boggling serve, just to let him know who was boss right away.

He was left-handed, so I served it in the direction of his forehand. The serve actually appears to go off the table, and then it curves back and hits the edge of table.

I served and it was a great one. But I suddenly heard a bang, like a firecracker, and the ball game back at over 100 miles an hour on the far edge of the table and bounced against the wall 35 feet behind the table. I did not miss it, because it came so fast I did not have time to swing at it! I could not believe what had just happened, and meekly announced the score, Love – 1! I tried another fantastic serve with the same result. And after three more “fantastic” serves, all returned by massive slams, it was Love – 5.

Then Jimmy said, “Doctor, maybe you should not use that type of serve. They were popular in Sweden about 20 years ago, but now everyone can smash them back. I asked what kinds of serves people were using now, and he said he’d show me.

Then he served an idiotic, slow serve that barely made it over the net, and I thought I could smash it back. But when I attempted to hit it, it went off at right angles, and I could not get it over the net! He had thrown it high in the air at the start of his serve, and then put some kind of fantastic spin on the ball, but blocked my site with his other arm, so I could not actually see what happened at the moment the ball hit his racked.

Then he did four more similar serves, all with the same result .Now it was my turn to serve again, and the score was Love – 10.

I lost five straight games to Jimmy, all by score of 21 to 0. Wow! It was stunning!

Then I asked Jimmy, “Do you have a rank or anything like?” He said, “Oh, I am second in the United States right now in my age division, but my main thing is shooting squirrels!” He winked as he said that, and then I saw what he meant!

Well, my excursion into the world of professional table tennis was quite the adventure, but I had to accept that I just could not get my body doing what my head wanted it to!

So I went back to something I was a little better at—psychotherapy and statistics (for research articles I was writing) and teaching. And I’ve enjoyed myself tremendously since then.

Still, I’ll never regret the time I decided to pursue my “true calling in life!”

Well, I’ll stop babbling now, but hope to hear from you!

David

Where Can I Find Your books?

Where Can I Find Your books?

Hi Dr. Burns,

Hello I was wondering do you still have the feel mood therapy workbook they no longer sell them in store or online and I’m a person that retain information if I can write will I’m reading, because I have the book and I’m not retaining the information very well

Thank you in Advance,

Shanta

Hi Shanta,

Thanks for the question. My books are all sold on Amazon, and other online book sellers, including:

  • Feeling Good: The New Mood Therapy
  • The Feeling Good Handbook
  • Intimate Connections
  • Feeling Good Together
  • When Panic Attacks

Hope that helps! You had the names wrong, so appreciate the chance to clarify! Let me know if you like any of my books.

All the best,

David

Photos from Our Sunday Hike

Photos from Our Sunday Hike

Hi web visitors,

I am attaching eight photos from this week’s Sunday hike, which included two hail storms. I hope you like the photos! One of our newest Tuesday group members, Maryam, took them.

As you can see, spring is in full swing here already. There is so much beauty and majesty in these photos, taken with a cell phone. You will see that some of the trees are already covered with white or pink blossoms. The tree with white blossoms is a really old plum tree. If we have enough bees, it may produce a large volume of fabulous plums. But it is a race with the birds and squirrels as to who gets them first! Usually we lose that one.

Danny, the other man in the photos,  drove something like two or three hours to hike with us on Sunday. That’s real commitment! The house in the photo is one we passed on the hike.

We had to avoid most of the trails which were excessively muddy due to all the rain we’ve had, but it was a terrific hike in spite of having to be on roads part of the time. The main hiking adventure is internal, at any rate, so the weather and trails are not overly important.

There were only three of us, due to the rain, and we were working, as usual, on personal relationship issues, which seems to be a popular topic among therapists who come to the Sunday hikes. The hikes provide an opportunity for therapists to work on their own issues, and also to learn and practice psychotherapy techniques, so we can improve the work we do for our patients / clients. It was an interesting and productive  hike, I think.

We focused on questions like how do you get to know someone? What’s the best approach when you are meeting someone who may interest you? Web visitors also ask these kinds of questions. In fact, one of them is a man who has asked for tips on flirting. I may devote a blog on that, if folks are interested, and encourage all of you to post their your tips and suggestions, as their are so many radically different theories about this!

 

David

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Is Love an Adult Human Need?

Is Love an Adult Human Need?

Hi Dr. Burns,

Hope you have time for another question. Maybe you can post this on your site.

In your Intimate Connections book you say that many people believe that they need a romantic partner to be happy (which you think is a false belief). Doesn’t this imply that people are either happy or unhappy, which is, or course, all or nothing thinking? Doesn’t happiness exist on a spectrum, from say 1 to 10?

Shouldn’t the question be, “Do people need a romantic relationship to achieve a certain level of happiness?”

To achieve a happiness level of 10, do people need a partner? If they could achieve a 10 without one, why would they bother attempting to then obtain one. Why bother trying to find a girlfriend if you’re not going to be any happier? How happy can one be without one?

Shouldn’t you change your statement to: people assume they can only achieve a happiness level of about a 2 without a partner when in actuality they can achieve a level of about a 7?

What are your thoughts?

Richard

Hi Richard,

Happiness, like all emotions, exists on a continuum, and you could measure it on a scale of 0 to 100, for example. So sometimes we are not happy at all, and other times we may be extraordinarily happy. The same is true of sadness, anxiety, anger, discouragement, shame, and so forth. Emotions do not exist in an All-or-Nothing way.

Our culture definitely teaches us that we need love to feel happy and fulfilled. In one of her famous songs, Barbara Streisand’s sings that “people who need people are the luckiest people in the world!” So most people naturally assume that we “need” love to feel a high level of happiness and fulfillment.

When I first heard Dr. Aaron Beck assert that love is not an adult human need in one of the weekly seminars I was attending during my research fellowship at the Penn Medical School, I had the thought, “My gosh, he must be a sociopath to say such a thing!”

But I decided to test what he was saying, spending more and more time alone, just to see what would happen. I did it as a series of experiments, using my Pleasure Predicting Sheet. It consists of several columns, and in the first column you schedule a variety of activities with the potential for pleasure, satisfaction, learning, personal growth, and so forth. In the second column, you record who you plan to do each activity with. Make sure you schedule some activities that you will do on your own, as well as activities you will do with others. In the third column, you predict how satisfying or enjoyable each activity will be, from 0 to 100.

Now you are ready for your experiment. Go ahead and do each activity, and after you’re done, write down how satisfying it turned out to be, between 0 and 100, in the fourth column.

When I did this, I was shocked to discover that I could be maximally happy when doing things by myself. This was a revelation to me, and at first it was hard to accept. These experiences definitely changed my thinking. But the conclusion was absolutely consistent with the basic premise of cognitive therapy, that our thoughts, and not external events, create all of our feelings, positive and negative. I have treated large numbers of people who were extremely depressed, even suicidal, who were very loved; but their minds were loaded with negative and distorted thoughts about themselves and their lives.

I am only touching on this topic in a superficial way here. You can read more about this notion in the first section of Intimate Connections, which is all about learning that you can be happy when you are alone. You can also read more about this in the chapter on “The Love Addiction” in my first book, Feeling Good: The New Mood Therapy. And you might want to watch the reality TV show, “Alone,” which just completed its third season. It’s all about being stranded in the wilderness alone for prolonged periods of time, to see how long you can survive. The winner receives $500,000.

The topic is extremely controversial, like so many topics in mental health / psychology. And everyone is pretty sure they are an expert who knows “the truth.” So the post might fire up some controversy.

At any rate, you asked why anyone would want to have a boyfriend or girlfriend, or friends at all, if you can be completely happy when you are alone. Well, there is a difference between “needing” something and “wanting” something. For example, I might want a fancy new sports car, but I don’t “need” one to be completely happy.

From a practical point of view, I have treated large numbers of single men and women who were having a terrible time in the dating world, and usually they were telling themselves that they “needed” love to feel happy. This made them come across as “needy,” and their neediness forced people to reject them. That’s because of the “Burns Rule,” which states that “people only want what they can’t get, and never want what they can get.” So if you need someone, you become what they can get, and they won’t want you.

So I always encouraged these single individuals to overcome their fears of being alone before I would teach them how to get people chasing after them. And this was nearly always effective. Once they no longer “needed” people, but had learned how to love themselves first, then they were far more successful in the dating world.

So that’s why all the chapters on flirting and such in Intimate Connections follow the initial section on learning to be happy when you’re lone.

Personally, I love to be alone! And many of the happiest moments in my life where moments when I was lone.

And I also love to hang out with others, and I love to give and receive love from those I’m close to as well. And that includes my family, students, friends, and even, or especially, our beloved cats!

Well, there my answer, Richard, but I’m sure we’ll get a ton of comments from folks who, like yourself, are hooked on the idea that we “need” love to feel maximally happy! I have created dozens of techniques to help folks overcome the fear of being alone, but that is perhaps for another day.

Oh, one last thing. If you have a firm belief that you cannot be happy when you are alone, it may function as a self-fulfilling prophecy. For example, I once treated a woman who’d been rejected by her husband, who was having an affair with his secretary. She told me she had proof she couldn’t be happy when she was alone, because she was alone and constantly miserable, for example when eating dinner.

I asked her what she had for dinner the night before. She said she sat in a chair facing the wall and ate a peanut butter sandwich.

I said, “Well, maybe that’s why you were feelings miserable. What would you have for dinner if you had invited your favorite person in the world for dinner? For example, some celebrity you intensely admire?”

She said she’s buy the best food at the grocery store and prepare a gourmet meal, with candles, music, etc. I suggested she might try doing that for herself, as an experiment, using the Pleasure Predicting Sheet. She predicted that shopping, cooking, eating would be 0% to 5%, a scale from 0% to 100%, because she’d be alone.

She also had a luncheon scheduled with her husband later in the week, and had predicted it would be 95%, since she wouldn’t be alone. She fantasized they’d talk about getting back together.

But she was shocked by the results of her experiments. Shopping and cooking a gourmet meal for herself were 95% satisfying. And then she sat down with herself, with music and candles, and ate the dinner, and it was 100%. She said she got so high—no drugs or alcohol, mind you—that she took herself out dancing (in the living room), and just loved being with herself. This blew her mind.

The luncheon with her husband was also mind-bending. He spent the entire lunch talking about what a wonderful lover his secretary was, and how they’d divide up their belongings for the divorce. And of course, he was an attorney, and his suggestions involved pretty much everything for him and nothing for her.

In the Outcome column of her Pleasure Predicting Sheet she recorded 0%. The data were simply not consistent with her belief that she “needed” her husband’s love to feel happy and fulfilled.

Then she asked me what she should do next. I told her that now that she no longer “needed” love, it would be pretty easy for her to do some flirting with attractive men she met, and I told her that as soon as she found someone she really liked, and she no longer even wanted her husband back, I promised her that her husband would then come crawling back to her.

And that’s exactly what happened. She met a handsome hunk of a guy who was also recently divorced, and they fell madly in love. That very day her Ex called and said he’d changed his mind, and begged for her to accept him back. But she didn’t. She told him she was far happier without him, and wanted the divorce to be accelerate.

Her husband called me in a rage. He’d referred his wife to me initially, because he was afraid she was suicidal, and he’d asked me take care of her. He shouted in the phone, “I told you to take care of her!”

I replied, “I did, I did!”

If you’re interested, you can read more about the story in Feeling Good. She was one of the first people I treated with cognitive therapy, way back in the early days! But I’ll never forget!

David

 

Hi Dr. Burns,

Thanks for your response. Here is mine.

You keep drawing a distinction between needing and wanting.

I don’t see the importance of that. You say you don’t need a sport car to be completely happy, but you may still want one. If you could be completely happy without one, why would you want one?

Also, in order to be completely happy (long-term, not just for a few seconds) what does one need? Do you agree with many psychologists that to live the happiest life you need four basic things:

1. enjoyable work

2. good friends

3. good hobbies

4. good romantic relationship

Richard

Thanks, Richard!

Excellent response! Can I post your response, and my email on my website, as part of the post, with or without your name? Beyond this exchange, that would be the end of the posting of exchanges, however, as it gets too long, perhaps.

Personally, my answer to your excellent question is no, but that’s just my take on it, and not some absolute truth. I don’t see these as “needs.” But you can set it up like that if you want, and think of these things like enjoyable work, hobbies, love, and friends as basic human “needs,” and this might not be a problem for you. As a “shrink,” I don’t try to teach people about some “right” or “wrong” way to believe or think about things. I simply try to help individuals with problems they are having.

Lots of people do not have enjoyable work, and yet they are quite happy. They see their work as a way to earn money, and they do things that are more interesting to them when they are not at work. There is no rule that says everyone “must” find enjoyable work.

When I was in college, I did construction labor in Phoenix for two summers. It was pretty demanding work, with pick and shovel, and also lots of sweeping with a big broom, and it was hot that summer, with little no shade on the construction sites. The temperature in the shade was usually 105 degrees, and the temperature in the sun where we were working was typically 135 degrees. One of the laborers I worked with was named Carmen, and he was constantly telling me I did not use the shovel or broom correctly, and he would show me better ways to dig or sweep.

I would not say that the work was “enjoyable,” but I was very grateful to have a job and the chance to earn some money. The hourly wage, due to the union, was $3.10 per hour (Local 383 of the AFL), which seemed like a fortune to me, since we did not have much money. Another summer I had a job filing checks in a bank, which was boring, but tolerable, but definitely not “enjoyable.” I did try to make it interesting, however. For example, I tried to learn about the lives of the other construction laborers I worked with, since in my upbringing I did not have the chance to meet lots of people who were doing construction labor for a living. I felt a bit intimidated, but they were all really kind to me, and I worked as hard as I could.

Many people, and perhaps most, do not have jobs that are especially enjoyable. Now, if they tell themselves, “Oh, an enjoyable job is a ‘need,’” then they might feel unhappy and pressure themselves a great deal, thinking they have somehow fallen short of some basic human need.” If they wanted help with their negative feelings, and only if they wanted help, we could use a great many of the TEAM-CBT skills to help them, and this would likely be a really easy problem to solve. But if they were not asking for help, then I would simply “Sit with Open Hands,” since I have no special expertise in what people in general “should” or “shouldn’t” think or believe. My task is to help individuals who are struggling with depression, anxiety disorders, relationship problems, or habit and addictions, assuming they want help.

The most fundamental error in psychotherapy, in my opinion, is trying to help someone who is not asking for help, as this nearly always triggers resistance and a kind of log jam between the patient and therapist may develop. Of course, if someone is ambivalent, and wants to dialogue about that, it can be very productive, and there are tons of TEAM-CBT tools we could use—Empathy, Paradoxical Agenda Setting, and Methods. For example, we could do a Cost-Benefit Analysis (CBA) and balance the Advantages against the Disadvantages of viewing an enjoyable job as a “need.” Then we could balance the advantages against the disadvantages on a hundred point scale. For example, is it 50-50? 60-40? 35-65?

Then we could do a second CBA, balancing the advantages against the disadvantages of thinking of an enjoyable job as a “want,” and balance the advantages against the disadvantages on a hundred point scale.

The way you use language is a personal decision. It is not so much the idea that one approach is inherently more “correct.”

Similarly, when you goof up at something, the way your think and use language will impact your feelings. For example, you can beat up on your “self,” telling yourself “I am a bad teacher,” or a “failure as a father,” or some such thing. These kinds of thoughts contain multiple cognitive distortions, such as All-or-Nothing Thinking, Overgeneralization, Labeling, Self-Blame, Emotional Reasoning, Mental Filtering, and Discounting the Positive, and they are hidden Should Statements as well. These distortions will probably trigger feelings of depression, shame, anxiety, inadequacy, loneliness, and hopelessness, because the negative thoughts sound so absolute and permanent.

Or instead, you can focus on the specific error you made as a teacher, or as a father, or whatever, and make a plan to correct it. These two approaches are a matter of personal choice, but they can have massive implications in terms of how we feel.

The idea that our thoughts create our feelings is also a spiritual notion, embedded in Buddhism and nearly all religious traditions. Buddha emphasized the importance of focusing on specifics, rather than thinking about our errors and shortcomings in global terms. He was one of the first to teach that our thoughts, and not our external circumstance or the events in our lives, cause all of our feelings, positive and negative. We are creating our own emotional reality at every moment of every day. This notion is some basic, obvious, and fundamental, that many people simply cannot “see” it, or grasp it. Understanding this notion is one form of enlightenment.

Many people with enjoyable work, good friends, wonderful hobbies, and great romantic relationships are depressed and suicidal—I have treated many of them in my career—and many people who lack these things are very happy. But again, it is a matter of choice how you want to think about your life. If you ruminate about things you don’t have, and you tell yourself that these are “needs,” how will you feel?

I go on Sunday hikes with members of my training groups at Stanford. The hikes are not a basic human “need.” I spent most of my life not going on Sunday hikes. So if the hikes are not a “need,” why do I go on them? That is the type of question you are asking. I go on the Sunday hikes because they are a lot of fun. It gives me the chance to do personal work with students and colleagues, and to get to know people on a deeper level. In addition, it is a nice way to get some exercise.

To me, wants and needs are very different. Why do we do anything? For me, I do things because I am alive, and grateful that life offers so many opportunities and experiences. We have a new kitten—sadly, my beloved Obie disappeared two months ago. He was my best friend and likely killed by a predator in the middle of the night, in the woods behind our house. I will grieve his loss for a long time. I still shout out his name when I am out jogging, thinking he might hear me and suddenly appear, even though I know he is gone. A neighbor kindly gifted my wife and me an adorable kitten they found abandoned by the side of Moody Road, near a trail I hike on. She was three weeks old and it was a rain storm. They took her home and gave her a loving home for several months. But they traveled a lot, and did not like to leave her alone, so they gave us this beloved kitten, Miss Misty, who is now 4 ½ months old. And what a joy she is! So cute and full of life, and love. But I do not think of Miss Misty as a “need,” but rather as a gift, or as a little miracle of sorts.

Dr. Beck once told an interesting story in our weekly training group when I was first learning cognitive therapy. He said he and his wife went to a night club to hear some jazz performance, and the man sitting alone at the table next to them seemed like he was having an extraordinarily good time, even though he was alone, Dr. Beck asked the man why he was so happy. The fellow said he was incredibly happy because he’d just gotten an extremely important promotion at work. Dr. Beck asked him what work he did, and what promotion he’d received. The man said he’d been working in a local bakery for 25 years, and he had the job of making the donuts in the kitchen in the back area of the bakery. But he said that earlier in the day, the manager said that he could actually arrange the donuts in the display area, and gave him a 10% raise, and thanked him for the excellent work he’d been doing for so many years. The man was beside himself with happiness! Dr. Beck talked to him a bit more and learned that the man was living alone and could not read or write, and had not graduated from fifth grade.

I guess the point Dr. Beck was making is that our thoughts, and not the facts of our lives, create our feelings. You can be miserable in the midst of abundance—like many of the depressed individuals I treated—or joyous in the midst of very little. It all depends on how you think about things.

Still, none of this is meant as persuasion, just examples to illustrate my own very different way of thinking about wants vs, needs. In my opinion, we “need” oxygen, food, and water to survive. The new reality TV show, “Alone,” illustrates this very well! But I do not believe that we “need” enjoyable work, love, hobbies, or friends, although all of these can be sources of pleasure and joy.

But that’s just my way of looking at things. Ultimately, we are all free to think about things in whatever way we want. And lots of therapists do like to emphasize the “needs” we have as human beings. And I would say this line of thinking is “politically correct,” too. Your point of view, Richard, is quite popular, and if it is working for you, then there is no real need to change!

David

Hi Dr. Burns,

Yes you can use my first name if you publish our emails. We could go on forever so i will respond briefly.

As far as four things people need for happiness, maybe we could add a fifth which would be good health (depression being bad health).

Also, there are people who are happy who have bad jobs but are they really a 10 on the happiness scale or more like an 8?

Thanks for your thorough response.

Richard

Hi Richard,

You are most welcome! And thanks for the good dialogue which will likely interest a few people. However, this blog may make some people mad (at me, not you), since my thinking is somewhat politically incorrect.

But once again, my answer is no. Good health is wonderful, but not a requirement for happiness, and certainly not a guarantee for happiness, either.

In addition, my hunch is that there is no “cap” on happiness one way or the other. I have had many patients test this theory with the Pleasure Predicting Sheet that I described earlier in the blog. An experiment can be a nice way to check these beliefs out, sometimes.

I’ve treated or known many people with severe illnesses who were tremendously happy and content with their lives. And I’ve treated many, of course, who were in great health, but miserably unhappy.

I had a pretty severe problem with my right hand years ago (reflex sympathetic dystrophy), and had to do hand exercises 18 hours a day for 6 months to get my hand back to normal, or close to normal. I also had to go for hand therapy several times a week in a gym designed for people with serious hand injuries.

I was always amazed at the cheerfulness and friendliness of many patients in that gym who had the most grotesque and horrible hand injuries you can imagine. One was a woman with extremely advanced arthritis in both hands, and her profession was restoring rare paintings. She could barely move her fingers! And I can remember a professional skier whose hand had been crushed by a truck, and it was as flat as a pancake, making it nearly impossible to hold onto those things that skiers hold while skiing. But they weren’t complaining, and had the most positive outlook on life.

And I can remember an African America high school student who was doing some kind of exercise on one of the hand machines next to me, so I struck up a conversation and asked him what he planned to do with his life when he finished his schooling. He said he was hoping to become a professional basketball player. Then I asked him about his hand injury—what had happened?

He explained that he was injured when using a saw in his shop class at his high school, and that both of his hands had been cut off. He explained that they tossed his hands into a bucket of ice water and rushed him to the University of Pennsylvania Hospital Emergency room, and that Dr. Osterman (who was also my doctor) had sewn his hands back on. And he told me he wasn’t giving up on his dream!

But there were usually one or two patients in the hand gym who were miserable complainers, nasty, demanding, and hard to be around—and usually their hand injuries were mild. So once again, it is our thoughts, and not the external circumstances, that create our emotions, positive and negative. But that’s just my mind-set, and others will have different ideas for sure!

I remember diagnosing terminal lung cancer in a woman I treated in our hospital in Philadelphia before I moved back to California years ago. I had been making rounds with the residents to prepare for my medical board examination when we moved to California, since I had let me medical license in that state run out and was pretty rusty on my memory of medicine.

The woman was very cheerful, and the residents who I made rounds with kept telling me that she “should” be more upset, as if her reaction to her diagnosis was somehow wrong, or involved denial, or some such thinking. But she told me that she was a deeply religious woman, and that she was extremely grateful that she’d had a good life, with two daughters who she loved and who loved her a great deal. She told me that she had nothing to worry about, and nothing to be upset about, because if it was God’s time to take her home to heaven, then she was ready to make the trip!

David

Does Tapping Work?

Dear Doctor David,

I am interested in your Scared Stiff anxiety workshop, as 95% of my primary care patients deal with this in some way, and I would argue that it is more common and in some ways more harmful than depression. I am a fan of CBT.

Question: is TFT (“tapping”) a lot of hooey or is there something to it? I have had some good personal experience, and would like to use it with primary care patients because I like simplicity and something that I can teach the patient to use at home (like deep breathing technique or affirmations). I like tools that the stressed patient can do RIGHT NOW, without an appointment or prescription, without spending money, without regard to insurance status, without needing more than 2 or 3 minutes, and without depending on an external source like the bottle of Jack, the pill (legal or otherwise), the partner, the “provider”, etc.

I respect your work, and you are an MD.  I would appreciate your thoughts on the TFT technique.

Kindest regards,

Lisa

Dr. David’s Answer

Hi Lisa,

Thank you for your question. TFT and EMDR combine something new (like tapping on your eye brow or jiggling your eyes back and forth) with exposure techniques that have been around for decades. I am skeptical that these types of distraction add much, if anything, to good, old-fashioned exposure. You can read about “Tapping” TFT if you click this link and you can read about EMDR at if you click this link

When I treat anxiety disorders, I combine a wide variety of exposure techniques with cognitive techniques, motivational techniques, and the Hidden Emotion Technique. You can read about these four treatment models in my book, When Panic Attacks, or in my psychotherapy eBook. I do not use eye jiggling or tapping on body parts during exposure, and have not found them to be necessary for outstanding or even dazzling results.

In my psychotherapy eBook I have a chapter entitled “The Clinician’s Illusion.” This refers to various ways that therapists and researchers fool themselves into believing things that may not be true. One problem I describe is called “coupling.” That’s where you combine an old, established technique, such as exposure, with some new technique, like eye jiggling or tapping on the eyebrow or whatever. Of course, exposure can be remarkably helpful, but you may mistakenly attribute the clinical improvement to the new technique that you are “coupling” with the older and more established technique.

In some cases, therapeutic enthusiasm may be due to the illusion of “seeing is believing.” If you use one of these newer techniques and your patient improves, it is natural to conclude that the treatment worked and that they theory is valid. But the special component you are using (such as eye jiggling, rhythmic knee tapping, or eyebrow or clavicle tapping) may, in fact, just be hooey, to use your language. The patient probably improved because of the exposure, and not because of the new component. Unfortunately, it is really easy for us to become “true believers,” especially if some new treatment is skillfully and aggressively marketed. Then we get invested and don’t like to be challenged, but challenging our thinking is the basis of science.

Another potential problem that confuses therapists and researchers alike is the placebo effect, which can be powerful. What’s the placebo effect? If people strongly believe something will help, it has a good chance of helping, even if it is nonsensical. When patients take an antidepressant and recover, or try some new treatment and recover, we think the pill or the therapy was the effective ingredient—but in most cases, the improvement is just due to the placebo effect.

I used to joke in workshops that we could create a new “ear tugging” school or psychotherapy, based on tugging on the ear lobes to let the evil spirits and pressures out of the brain, so the brain can get back into a proper balance again. I used to say that if you could get your depressed patients to believe in this notion, 35% to 50% would recover in three weeks as a “result” of their ear-tugging, especially if they work hard and do their five minutes of “ear tugging” homework every night. But in reality, it would just be the placebo effect.

Therapists in my workshops seemed to get a kick out of this example and laughed when I illustrated “ear tugging.” However, several years later a physician approached me during one of the breaks at my workshop, and asked if I’d heard about a fantastic new treatment for depression and anxiety. He had literature promoting the new treatment and wanted permission to distribute it. He swore that the new treatment had a 90% success rate and worked almost immediately.

I was intrigued and asked what the treatment was. He said it was called “Ear Tugging.” This is the honest truth. And he had paid quite a lot of money to attend a training program in this new “treatment!”

We all want to believe in something. People who challenge our beliefs are sometimes punished. In part, that’s probably why Socrates was put to death and forced to drink the poison hemlock–the people of ancient Greece did not want their cherished beliefs challenged.

Well, I’m no Socrates, and my thinking about TFT and EMDR may not be fair or accurate. It’s just my take on things, and I want to apologize ahead of time if I am way off-base. I’m just sharing my own thinking, for what it’s worth, but remember that I don’t know all the answers, and often my point of view is wrong.

Please let me know if I can post your interesting question, and my reply, on my website.

All the best,

David D. Burns, M.D.

Lisa’s Reply

Dr. Burns —

I’m happy to be part of your online discussion, and thank you for this thoughtful perspective – I appreciate it very much!

Didn’t Galileo face a similar problem as Socrates when he proposed that the Sun and not the Earth was the center of the world?  There is so much we don’t fully perceive and thus can’t understand, and so much associated fear.

I think it is important and interesting to collaborate broad-mindedly in figuring out what works, and in differentiating the genuinely effective intervention from its lucky-underwear surroundings.

These effectiveness questions are interesting and important, because isn’t the use of science-based exploration how CBT evolved into TEAM and how things improve generally?  I think so, and I am glad I asked you.

I come from a long line of people with depression and some bipolar as well, as well as apparently menopause-induced psychosis. That’s why I have always been interested in exploring what helps and what doesn’t and why.

Revolutionary to me was the idea that you are more than your thoughts, and that it is possible to change your frame of mind by working with the content of your thoughts. The shift from a negative to a positive orientation through thoughts and behaviors over which one has some control has been enormously helpful to me and makes so much sense.

So thank you!

And thank you for this response, and I will hope to attend one of your workshops in the future.

Kindest regards,

Lisa

Dr. David’s Second Response

You are so right. There were decades of suffering due to the Copernican revolution. And you are right that therapy methods can evolve rapidly, just as computer chips keep getting faster and better. Every week we develop new treatment and training techniques at my weekly training groups at Stanford and other locations around the SF Bay region.

Getting quantitative feedback from every patient at every session is tremendously helpful, both from a clinical and from a research perspective, because you can see what really works, and what does not.

I hope to meet you at an upcoming workshop!

All the best,

David Burns, MD

Which Book Will Help Me the Most?

Which Book Will Help Me the Most?

Dear Dr. Burns

I suffer from social anxiety and depression. I feel that I don’t need to see a therapist and believe that CBT will be enough to help me.

I have purchased three of your books: The Feeling Good Handbook, Ten Days to Self Esteem and Intimate Connections. This might be overkill but I really wanted to cover all the bases.

However now I am confused and don’t know where to start and how to manage the learning.  Which book should I work on first and how long do you think it should take to work through any given book? I believe somewhere you suggest that the Feeling Good Handbook this should be completed within 30 days. Any advice would be much appreciated.

Thanks

Beth

Dr. David’s Answer

Hi Beth,

Thank you for your question. There are no rules of the road. Ten Days to Self Esteem is the shortest and easiest book, with exercises you can complete at each of the 10 steps. Essentially, it is a 10-step program to teach you the basics of CBT and to show you how to boost your own self-esteem. The publisher has insisted on the name, Ten Days to Self Esteem, but I would prefer the name, Ten Steps to Self-Esteem, so you can complete it at your own pace.

Intimate Connections can be very helpful for loneliness and shyness–it is about the power dynamics of dating to some extent, and how to communicate, how to flirt, how to get people to chase you, how to deal with rejection, and so forth. It also shows you how to overcome the fear of being alone. It is somewhat autobiographical, too, since these are issues I struggled with when I was growing up.

The Feeling Good Handbook is a strong book with a focus on depression as well as anxiety, including shyness, and relationship conflicts as well.

I would start with any one of them and focus on it. There is considerable overlap, so once you learn the techniques they will all flow very easily for you. The key is doing the exercises while you read. The people who do the exercises are almost always the ones who benefit the most from any of my books.

It is kind of like riding a bicycle. You can’t learn to ride by reading about bicycles or watching people ride bicycles. You’ve got to get on a bicycle and give it a try. It might feel a bit shaky, or new and unfamiliar at first, but you can quickly learn to ride.

Research studies have shown that many people can use these books without a therapist and benefit tremendously. Some people with more severe or long-standing will also need the help of a skillful and compassionate therapist, of course.

I am now working on something new and extremely exciting, and will announce it as soon as possible on this website.

Thanks so much!

David Burns, M.D.